MRS. TRACI S. MATTERESE (NPI# 1447508262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447508262 |
| Entity Type | Individual |
| Full Name | MRS. TRACI S. MATTERESE |
| Credential | M.A. C.A.S. |
| Practice Address |
623 New Loudon Road Latham NY 12110 |
| Practice Telephone | 5187821178 |
| Practice Fax Number | 5187823334 |
| Mailing Telephone | 5187821178 |
| Mailing Fax Number | 5187823334 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
NY | Behavioral Health & Social Service Providers |
| Street Address |
623 NEW LOUDON ROAD |
| City | LATHAM |
| State | NY |
| Zip Code | 12110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659654788 | Anna Marie Chandler | Speech-Language Pathologist | 623 New Loudon Road, Latham, NY 12110 | 2011-09-26 |
| 1053665976 | Celia M. Sofia | Specialist | 623 New Loudon Road, Latham, NY 12110-4031 | 2012-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154963973 | Bayley Archinal | Physical Therapist | 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 | 2019-10-14 |
| 1114410701 | Kimberly A. Hostig Licensed Clinical Social Worker Pllc | Clinic/Center | 8 Stanley Cir Ste 11, Latham, NY 12110 | 2018-06-08 |
| 1710477260 | Colleen Phillips | Physical Therapist | 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 | 2018-05-10 |
| 1528574779 | Deborah Cannon | Specialist | 33c Waterford Avenue East, Latham, NY 12110 | 2017-12-26 |
| 1730600149 | Michael Navarrete | Dentist | 231 Wade Road Ext Unit 101, Latham, NY 12110 | 2017-07-06 |
| 1316499452 | Colonie Asc LLC | Clinic/Center | 207 Troy-schenectady Rd, Colonie, NY 12110 | 2016-10-25 |
| 1720539950 | Tania M Durante | Pharmacist | 1057 Troy-schenectady Rd, Latham, NY 12110 | 2016-10-24 |
| 1417344987 | New York Epilepsy Medicine, PC | Clinic/Center | 3 Lear Jet Ln Ste 203, Latham, NY 12110 | 2015-04-22 |
| 1346664752 | Lauren Gannon | Registered Nurse | 95 Forts Ferry Road, Latham, NY 12110 | 2014-02-06 |
| 1649522756 | Natasha Kapsaroff-ruiz | Nurse Practitioner | 654 Watervliet Shaker Rd, Latham, NY 12110 | 2012-10-12 |
| Find all providers in zip 12110 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154553022 | Carrie L Trimarchi | Psychologist | 20 Century Hill Dr, Suite 202, Latham, NY 12110-2116 | 2009-08-11 |
| 1912443391 | Audra Francis | Psychologist | 7959 State Route 124, Latham, OH 45646 | 2017-01-10 |
| 1801049143 | Katherine Lawlor | Psychologist | 711 Troy Schenectady Rd, Suite 216, Latham, NY 12110-2442 | 2008-10-30 |
| 1023260171 | Cheryl L Buckley | Psychologist | 711 Troy Schenectady Rd, Suite 216, Latham, NY 12110-2442 | 2008-10-21 |
| 1245482298 | Angela Tobin | Psychologist | 711 Troy Schenectady Rd, Suite 216, Latham, NY 12110-2442 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860612 | Zoe Spiegel | Psychologist | 20 Harding Dr, New Rochelle, NY 10801-4610 | 2020-10-28 |
| 1053910059 | Erin Elizabeth Gurdineer | Psychologist | 131 South Third St, Northville, NY 12134-0608 | 2020-10-21 |
| 1114534310 | Alana May Sandberg | Psychologist | 10421 68th Dr Apt A20, Forest Hills, NY 11375-3475 | 2020-09-30 |
| 1437766177 | Danielle Brudner | Psychologist | 18 Cygnet Rd, Congers, NY 10920-1790 | 2020-09-27 |
| 1023624145 | Karleen Marie Gabriel | Psychologist | 35 Steven Pl, Smithtown, NY 11787-5419 | 2020-09-23 |
| 1730795832 | Erin A Hyle | Psychologist | 9 Maywood Ave, Rye Brook, NY 10573-2401 | 2020-09-23 |
| 1083220826 | Tina Ruggiero | Psychologist | 61 Fox Ct, Manorville, NY 11949-2613 | 2020-09-17 |
| 1952917650 | Margaret Jane Willard | Psychologist | 167 15th St Apt 2l, Brooklyn, NY 11215-4849 | 2020-09-17 |
| 1902410137 | Dana Levine | Psychologist | 7 Chester Dr, Great Neck, NY 11021-4904 | 2020-09-04 |
| 1871107946 | Michele D Jefferson | Psychologist | 66 Main St Apt 525, Yonkers, NY 10701-8853 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. TRACI S. MATTERESE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.